If you live in a large metropolitan area, chances are you have been either a patient or a visitor in an academic medical center that has 500 to 1000 beds. If you live in a rural area, you are probably more familiar with a small local community hospital with less than 100 beds.
Because of healthcare mergers and acquisitions, these two different kinds of hospitals are likely to be part of one integrated health system. While different in size and scale, they both deliver healthcare to their community 24×7.
Small, independent hospitals are often very agile, extremely customer service oriented and supported by a loyal community. In IT, the staff are often generalists and less specialized. They may have a single integrated system from one vendor with basic functionality and limited integration points with other applications.
In contrast, large academic medical centers can be slow to make changes and appear more bureaucratic. They provide advanced medicine with subspecialists and clinical services not found elsewhere. They have to work harder to create a culture of customer service. Their community is broader and they attract patients from greater distances, including international patients. And their IT teams are larger with many specialized roles. In addition to their core electronic health record, they have many specialized departmental applications, many interfaces. Overall, it’s a far more complex environment.
So how do these different profiles mesh at merger time? Continue reading
It’s that time again. Time to close out my current interim CIO engagement and transition to the new CIO. I’m delighted to share the news that Stony Brook Medicine has hired Kathy Ross as their next CIO. She starts July 24th and we will have a few weeks together to complete the transition.
Kathy brings extensive healthcare CIO experience having served for many years as a CIO within Ascension Health. She is no stranger to Cerner, our core EMR vendor. But walking into a new environment with all its complexities and uniqueness is a challenge for the most seasoned leader.
We can only have one CIO at a time so day one, it will be Kathy. I will work out of a temporary space nearby. My focus and role will be to support her and provide as much background information as I can to ensure she gets up to speed quickly.
While I have only been serving as interim CIO since early March, my plan for what I need to fill her in on is long and growing. It includes a review of where we’re at on my focus areas during this interim. We’ll block time to review together key background information and issues needing attention. And we’ll do meetings together with everyone on the IT leadership team as part of the handoff.
I learned at my last interim to block out chunks of time to review everything on the transition outline and not let the usual day to day meetings fill all available time. Continue reading
Telehealth or connected health as some call it, takes different forms depending on the provider organization and their strategy. The primary driver may be extending geographic reach by providing telehealth services to rural areas. Or it may be largely a focus on consumer engagement.
Regardless, there are common themes for successful initiatives. Based on my experience in several healthcare systems in recent years, I offer these tips for success:
Strategy is key – The organization must first determine what the key drivers are for the initiative. Is it to extend reach or provide an easier patient experience or a combination?
Tactics and specific programs will follow – Once the strategy is clear, which specific clinical services and offerings are needed the most will become clear.
Physician leadership is needed – If the focus is on extending reach of certain clinical services, physicians are at the center and must provide overall direction. For consumer-focused services, ambulatory services or strategic planning leadership may play a more central role.
Operational issues and decisions must be considered early on – There are legal and billing factors along with workflow issues for clinicians and staff to work out before any implementation. Continue reading
Communicate, communicate, communicate. How often have you heard it said that you can’t communicate enough?
A best practice for CIOs is to have “all staff” meetings at least quarterly or semi-annually. Regardless of the size of the IT department and the logistical challenges of getting people in one place, these meetings have value. Depending on the geographic spread of the IT team and availability of meeting space, you can always leverage technology to allow staff to dial in from their workspace.
Connecting with colleagues that they only hear on conference calls or “see” via email has value. If you are able within your budget to provide food, all the better to encourage social time before or after the actual meeting.
Such meetings allow you or guest speakers to provide the big picture on your organization’s strategy and priorities so everyone understands how their work fits in. You can communicate key updates and information on major projects and new processes that impact all or most of the staff. You can use it as a forum to provide education on key topics that all IT staff need to understand such as cybersecurity or bring in a motivational speaker.
At one organization where I served as CIO, shortly after I started, one of my direct reports was quick to tell me the exact number of years, months, and days since their last all staff meeting. How do you really feel about that was what I wanted to ask him. But I quickly understood he was representing staff who missed those meetings and wanted them re-introduced. I did ask why they were discontinued. The story I got was that the previous leader was asked a difficult question by a staff member, felt on the spot and didn’t want that to happen again.
As a leader, I welcome questions, even if I can’t answer them. Continue reading
I am regularly reminded how much young working couples with children need family support systems. Even with the new more flexible work arrangements and the ability to work from home occasionally or on a permanent basis, working parents need help from time to time.
We have four young working parents in our family. They balance the demands of their jobs and raising young children. That’s my two daughters and our sons-in-law or as my husband called them on Father’s Day, “active duty dads”. And he of course is an “active duty grandpa” when needed.
My oldest daughter is a nurse practitioner who works three 12 hour shifts a week and a fourth shift one week a month. She has an hour plus drive each way to the hospital. She leaves the house before her 1-year-old and 2-year-old children are awake. She gets home in time for bath and bedtime stories.
On the days she works, my son-in-law gets the children up, dressed, fed and off to the day care center. He is a senior loan officer at a mortgage company with an office in downtown Boston. He takes the train in and out and works from home a few days a week. Continue reading
What is a “frenemy”? According to Dictionary.com: “person or group that is friendly toward another because the relationship brings benefits, but harbors feelings of resentment or rivalry”.
Within health care organizations, there is a lot of history between the people who support the medical devices that touch patients and those who support the information systems used by clinicians. It has not always been positive and collaborative. In fact, there are such differences in the culture of each group that they don’t always get along. Maybe they are even “frenemies” in some organizations.
In your hospital, you may know the function as Biomedical Engineering, Biomed, Clinical Engineering or Health Technology Management (HTM) as it is now called as part of elevating the profession within healthcare. Those in the field now refer to themselves as “HTMs”.
AAMI (Association for the Advancement of Medical Instrumentation) is a standards development organization and the professional society for HTMs. AAMI is celebrating its 50th anniversary this year. Its mission is to advance safety in healthcare technology.
Four years ago, I was the first CIO ever to be elected to the AAMI board when AAMI leaders recognized the trend towards HTM and IT convergence and integration. I have provided the IT perspective to the AAMI board as the HTM profession continues to evolve. Continue reading
Last week was teacher recognition Sunday at our church. The many people who volunteer in our children’s religious education program were recognized and thanked for their service.
The title of our minister’s sermon was “A Teacher Is One Who Talks in Someone Else’s Sleep”. With the influence of teachers in all situations in mind, he asked us some key questions:
- Who is speaking to you?
- Who are you speaking to?
- What messages are you sending?
As a leader, this resonated with me. Leaders are teachers in every sense of the word. We teach by what we say and what we don’t say; what we do and what we don’t do. We teach with words and gesture. We teach with how we respond to situations. We teach in how we treat people regardless of their position and level in the organization.
So, what kind of teacher are you? And what kind of teacher do you want to be?
Sheryl Sandberg, Facebook COO, has said, “Leadership is about making others better as a result of your presence and making sure that impact lasts in your absence”.
When I take on a new position, I share with my team my values and guiding principles. I want them to know what is important to me and what I expect. And I continually reinforce those messages as we work together. Continue reading
This week marks three years of blogging for me. People still ask me where I find the time and how I get ideas for topics. My answer is always the same. I make it a weekly discipline – shaping the ideas during the week, writing a near final draft on Thursday night, then finalizing and publishing it first thing Friday morning. The ideas continue to flow though I’ll be the first to admit there are some Thursday nights when I’m still looking for inspiration.
Just think how I felt the Thursday when I saw this tweet from someone I follow?
“Tomorrow is Friday and we all know what that means! No, not just Cinco de Mayo but @sgschade blog comes out! #anticipation”
No pressure I thought. Fortunately, it was the week I had shadowed a nurse and my blog topic was obvious.
By the numbers, there have been close to 75,000 total views. Who would have thought that three years ago? I remember someone asking me who I thought would read my blog besides my family and close friends. Believe me, I have a small family who doesn’t always read it and few close friends. Continue reading
What consultant doesn’t want to work close to home as much as possible? But you go where your clients are and you get used to traveling.
It was one of those weeks. There was the usual 2-hour drive plus the 1 hour ferry ride to my interim CIO engagement on Long Island. Monday was the first time I worried about missing the ferry. My “wiggle room” on the drive part evaporated with bumper to bumper traffic as soon as I got on I-95 in Providence. I sweated it but I made it!
Then there was a same day trip from New York to Chicago for a CHIME Education Foundation Board retreat. It seemed like a good idea when we agreed to fly in and out the same day but reality of that can be brutal – a very long day!
And finally, there’s the commuter rail train ride into NYC to meet my husband for the holiday weekend.
I’m happy to not depend on airports for my current weekly commute compared to many who are truly “road warriors”. I feel a little spoiled. My biggest stress is whether I’ll hit traffic on I-95 and have to take a later ferry.
When I was the interim CIO at University Hospitals in Cleveland last year, it was a predictable 3.5-hour drive from Ann Arbor. A few times I ran into huge traffic jams and a long out of the way road construction detour. But it was mainly a predictable weekly commute. And productive when I could get some calls done during the drive.
Once we moved to the Providence area, it meant a weekly flight. The Providence airport has fewer direct flights. I had to choose between connecting flights which increase potential delays or the longer ground transportation to get direct flights out of Boston. I chose the latter.
Then my current engagement on Long Island came up. Driving through NYC or flying was a non-starter. It was a “go” when I learned about the ferry option. Continue reading
As we all watch events in Washington unfold, each of us knows that the organizations we work for expect us to behave ethically in all that we do. We sign confidentiality agreements; we complete conflict of interest disclosures and we receive ethics training.
Whether you consider yourself a “rules follower” or one who likes to “ask for forgiveness, not permission”, you know that you must act ethically and lawfully.
I appreciate the advice I received from a boss early in my career – always do what’s right for the organization. If there is any doubt when I fill out my conflict of interest form, I error on the side of disclosing more rather than withholding information.
And then there’s nepotism – something both small and large organizations need to manage. They figure it out. Unless you are a family owned business, you should not be hiring or managing family members.
I worked at an organization that was named by the Ethisphere Institute as a “World’s Most Ethical Company” five times since 2012 – University Hospitals in Cleveland, Ohio. Their Chief Compliance Officer, Kim Bixenstine, and the entire executive team took great pride in this honor. And they should. University Hospitals is one of only seven healthcare providers named to the list in 2017.
Ethics starts at the top. Continue reading